Playing the PC version of Surgeon Simulator, Bossa Studios' gory slapstick operation game, was like being in charge of a mechanized shell of a human whose arm, hand, and individual fingers were each run by tiny mech pilots. The controls were meant to be a bit off, leading to funny but not always fun scenarios where you'd fumble about with dangerous tools around a deeply unlucky patient.

I enjoyed the game at the time, back in 2013, but didn't pay much attention to any of the later updates or ports to other platforms. That said, I was pretty into the idea of returning to Surgeon Sim in virtual reality with much different controls. And different they are, but not in the way you'd expect.

Content-wise, this is largely the same Surgeon Sim you know and potentially love. You'll bash in ribs, pluck eyeballs, crack skulls, and smash rotten teeth in the name of medicine. On that front, it's as ridiculous and borderline-too-gross as ever. Sometimes you'll perform procedures in the back of a moving ambulance; other times, you're in space, fighting the good fight against gravity.

In terms of execution, Surgeon Simulator: ER, at least on PlayStation VR, is a hot mess. That goes for players using dual Move controllers, one for each floating hand, or those who opt for a single DualShock 4 gamepad, which works essentially the same way but is trickier in practice due to the way the PS4 camera's tracking functions (it needs to see your controller's light at all times, and that can hinder your movement). In both cases, you'll use buttons to "active" your fingers, allowing you to firmly grasp a tool and then wave your hand to, for instance, obliterate ribs with a hammer. That's the idea, anyway.

Taking things back a few steps, it can be a struggle to even pick up a tool, depending on how small it is and where it's situated in the operating room. Tweezers and scalpels are among the worst offenders. If part of your hand comes into contact with a physical object -- including the very table on which your tool is sitting -- it'll go skeletal and ghostly, preventing you from grabbing the item until you pull way back and try again. This collision-detection system is sensitive to the point of absurdity, and although Surgeon Simulator is not meant to have perfectly sensible controls, this goes beyond that. And it's also not solely a matter of the PSVR's inconsistent tracking. I didn't have these issues in Job Simulator.

When the controls don't bug out quite so much and you get a sense of how to play very carefully to avoid the common pitfalls that lead to restarts, Surgeon Sim: ER is surprisingly easy. But that's if you don't just give up. After my first session, I never wanted to play again. "Broken, broken, broken," I thought. On the second attempt, I fared better, but remained annoyed. On the third, there were still clear problems with the way my hands were being tracked, and with some sketchy-as-hell physics mishaps, but something clicked inside me, and I was able to perform a dozen or so operations in a row with minimal failures. At that point, I flew through it. This is a game you could theoretically beat in a single sitting, but there's replayability baked into the procedures, optional goals, and strange secrets.

For its part, Bossa Studios has publicly stated that it "got [the controls] wrong" after the game received scathing feedback from PSVR players. The plan, according to the team, is to offer "absolute tracking" (which is what the Vive and Oculus versions use) and make the collision detection on your hands "more gracious." I didn't really have a tough time with the former complaint -- the "relative tracking" allowed me to reach things that would normally put me outside the PlayStation Camera's necessary gaze and into a so-called dead zone -- but the latter flaw is the true annoyance. It's a game-killer.

As it stands, you should absolutely hold off on Surgeon Simulator: Experience Reality for PlayStation VR until the controls are overhauled in the planned update. I ended up having some fun once I learned how to work around those glaring issues to a certain extent, but even in the best of times, it was a struggle. It's a shame the launch went this way, because there's an entertaining VR experience buried in here.

[This review is based on a retail build of the game provided by the publisher.]

Jordan is a founding member of Destructoid and poster of seemingly random pictures. They are anything but random. Disclosure: I backed Double Fine Adventure and Awesomenauts: Starstorm on Kickst... more + disclosures

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